Basic Information
Provider Information
NPI: 1548923923
EntityType: 2
ReplacementNPI:  
OrganizationName: WHEELING HOSPITAL INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 MEDICAL PARK
Address2:  
City: WHEELING
State: WV
PostalCode: 260036379
CountryCode: US
TelephoneNumber: 3042433000
FaxNumber:  
Practice Location
Address1: 1 MEDICAL PARK
Address2:  
City: WHEELING
State: WV
PostalCode: 260036379
CountryCode: US
TelephoneNumber: 3042433000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/21/2021
LastUpdateDate: 10/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HARRISON
AuthorizedOfficialFirstName: DOUGLASS
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT & CEO
AuthorizedOfficialTelephone: 3042433000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RE0101X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
207RG0100X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
207RH0003X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207RI0011X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
207RI0200X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
207V00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207VM0101X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
207ZP0102X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
208G00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery) 
208M00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansHospitalist 
363L00000X  N193200000X MULTI-SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
367500000X  N193200000X MULTI-SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
207Q00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home